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It may lead to elevations in liver function tests, but it does not usually cause severe or lasting damage. Isotretinoin is a prescription drug for the treatment of severe or persistent acne. It may be a suitable option when other treatments for acne have not been effective. Isotretinoin is the generic version of this medication, which people often refer to by its original brand name, Accutane. However, this brand is no longer on the market. Other brand names include Absorica, Amnesteem, Claravis, Myorisan, and Zenatane. A course of isotretinoin treatment may take 4–5 months. During this time, people will need monitoring to check for any adverse side effects. One possible side effect is liver damage, although this is uncommon. In this article, we look at the potential effects of isotretinoin on the liver, how to protect the liver while taking the medication, and other possible side effects. What is isotretinoin Accutane and what does it treat Share on PinterestOlga Sibirskaya/StocksyIsotretinoin is a retinoid and derivative of vitamin A. A doctor may prescribe isotretinoin to treat severe or persistent acne or some types of skin, neck, or head cancer. Isotretinoin works to reduce the size of sebaceous glands and lower sebum production, which helps decrease acne. Isotretinoin may also work to reduce cell proliferation. People take isotretinoin orally in capsule form. Due to the potential side effects of isotretinoin, a healthcare professional will need to monitor people while they are taking the drug. This monitoring may involve blood tests, liver function tests, and checking for any other side effects. Liver side effects Isotretinoin may lead to higher levels on liver function tests. Liver abnormalities on a liver test can occur in up to 15% of people who take isotretinoin. Isotretinoin may increase serum aminotransferase, which can be an indicator of liver damage. There is no known reason why isotretinoin may elevate serum aminotransferase, but high dosages of the drug may have a toxic effect on the liver. However, it is rare for isotretinoin to cause abnormally high results in a liver test, and it is rare for the drug to lead to liver injury. Abnormal liver test results in people taking isotretinoin are usually temporary and may resolve while people are still taking the medication. Abnormal liver test results will usually not cause any symptoms. How to protect the liver while taking isotretinoin A doctor will need to monitor people with regular liver tests while they are taking isotretinoin to check for any liver abnormalities. Increased levels of serum aminotransferase usually resolve without treatment, and changes in dosage or medication may not be necessary. However, if serum aminotransferase levels reach more than five times the upper limit, a doctor may discontinue the medication. Before taking isotretinoin, a person must have a blood test and agree to certain terms, which include:seeing a doctor or dermatologist every 30 days for monitoringtaking any necessary medical teststaking extra steps to avoid pregnancy It is important that people let the prescribing doctor know if they are taking any other medications, herbal remedies, or supplements before taking isotretinoin. The American Liver Foundation notes that people can help promote good liver health, in general, by:maintaining a moderate weight to reduce liver fat, which can lead to non-alcohol-related fatty liver diseaseeating a nutritious, balanced diet and limiting the intake of saturated fats, added sugars, and refined carbohydratesdrinking plenty of waterexercising regularlyavoiding toxins, such as additives, insecticides, and cigarette smokeavoiding using illegal drugsavoiding contaminated needles checking that a studio has strict hygiene practices before getting a tattoo or body piercingletting a healthcare professional know if contact with another person’s blood occursavoiding sharing any personal items, such as razors, toothbrushes, or nail clipperspracticing safe sex to reduce the risk of hepatitis B or hepatitis Cusing warm water and soap for washing the handsgetting vaccinated against hepatitis A and B People will also need to talk with a doctor about whether it is safe for them to drink alcohol while taking isotretinoin. Other side effects The most common side effect of isotretinoin is dry skin, particularly dry lips. The medication can also cause dryness of the mouth, nose, or eyes, as well as increased sensitivity to the sun. People will need to take steps to protect their skin from the sun while taking isotretinoin, such as wearing sunscreen. Due to increased skin sensitivity, people will also need to avoid certain skin procedures, such as waxing, dermabrasion, or laser therapy, for at least 6 months after stopping isotretinoin. Other possible side effects of isotretinoin include:increased triglyceride and cholesterol levelsincreased inflammation levelsitchingskin irritation or fragilitynosebleedsthinning hairskin infectionsrashbone or joint painmuscles aches Other potential risks of isotretinoin include:Forestier’s diseasevision and hearing losspancreatitisincreased pressure inside the skulldepression and suicidal thoughts or behaviors Isotretinoin is not suitable for people who are pregnant or planning to become pregnant. When to contact a doctor People taking isotretinoin will need to see a doctor every 30 days for monitoring, which may include blood tests and liver function tests. If people have any symptoms of jaundice, they will need to contact the doctor as soon as possible, and it may be necessary to discontinue the medication. The symptoms of jaundice include a yellowing of the skin and eyes. People will also need to contact the doctor if they have any concerns about the symptoms or notice any changes in their mental health. Outlook A course of 15–20 weeks of daily isotretinoin may lead to a complete, prolonged lack of acne symptoms. Isotretinoin may cause liver abnormalities in up to 15% of people taking it, but these are rarely significant enough to require discontinuation of the medication. Elevations in liver function tests usually do not cause any symptoms and may resolve while people are still taking isotretinoin. Liver injury from isotretinoin that is significant enough to appear in testing is very rare. In the United States, people will need to agree to the iPLEDGE program to acquire an isotretinoin prescription. This program ensures that the person meets certain requirements, such as following the advice of a healthcare professional, agreeing to take steps to avoid pregnancy, and taking any necessary medical tests. Summary Isotretinoin is a prescription retinoid to treat severe acne. It may cause elevations in certain liver enzymes that can be an indicator of liver inflammation or damage. Abnormal liver test results from isotretinoin are not usually a cause for concern, and they may resolve while people are still taking the drug. It is rare for elevated liver function tests from isotretinoin to lead to discontinuation of the drug. Regular monitoring and testing will ensure that any elevations do not reach harmful levels. People can also take steps to protect their liver while taking isotretinoin, such as avoiding alcohol, maintaining a moderate weight, eating a nutritious diet, and getting regular exercise. Last medically reviewed on August 15, 2022DermatologyLiver Disease / HepatitisDrugsMedically reviewed by Alana Biggers, M.D., MPH — By Beth Sissons on August 15, 2022 Latest newsWhat sets 'SuperAgers' apart? 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